Sunday, May 25, 2008

Suicides are Not Painless

Suicides are painless. That line from the MASH TV show theme ran through my head the other day and I thought of the man with no face. Suicides are not painless. In fact they inflect more long lasting pain than they relieve. I discovered this the night a man put a shotgun under his chin and pulled the trigger. I had been to many attempts and successes over the years but this is the one that stands out above the others.


The only furniture in the apartment was a single chair. There was no TV, no table, nothing but this single chair in the apartment. The man had placed the chair in the center of the room and put the shotgun under his chin and pulled the trigger. When we arrived we found him still sitting up right appearing normal for all intents and purposes except he had no face. It looked as if someone had taken an ice cream scoop and scooped out his face leaving behind dried blood, broken bone and torn tissue. He had left no note or explanation for this last act. A faceless man sitting in a chair in the middle of an empty room, with not explanations, it had to be some kind of reflection of the life he had led, of the things he had done or had been done to him that led him to this end.


There was nothing for us to do but call him and wait for the cops. We loaded the gear back on the truck and waited. The cops, not wanting to do the paper work, were avoiding the call so we had to sit there with the person who had found the body and called. It was his son. He sat on the curb saying nothing for sometime. We stood around trying to give him some space. He finally began to talk maybe not to us as much as to himself.


He kept asking why but did not have any answers that gave him any peace. The pain of his loss was palpable. But the burden that he was going to have to carry was what struck me. The image of that single chair and the faceless man sitting in an empty room with the ceiling covered in gore would be etched in his mind for the rest of his life. With no note he could only guess why someone would do such a thing. It was as if he had done it to his son as well as to himself. He must have known it would be his son who would find him. It seemed such a cruel act to others more than relief for his pain.


I had seen how suicides were treated in the ER’s over the years. The doctors and nurses treated them derision and medical treatment that bordered on cruelty. When I would bring overdose that attempted suicide to particular one doctor he would always smile and order the largest NG tube he could, the “garden hose” as he would say. I never understood their feelings until that night, when I saw the impact it has on those around them. I never saw terminally ill patients who had real choices to make just people acting out, crying for help. I would always talk to them and try and “help” them during the time I saw them.


As I sat there with the son letting him talk I began to feel the real pain a suicide inflicts on those around them. It was going to change the son’s life in so many ways. It would change everyone’s life connected to him. It would add to the burdens in their own lives. The man suicide was so much like dropping a stone in a pond but the ripples were those close to him pain. Those ripples would be felt for the rest of their lives. The cops came, we loaded on the truck and left the scene. But that the guy with no face and his son on the curb never really left me. 


After the man with no face I changed. I saw those attempted who suicide the same way that the doctors and nurses did. As an act that inflects much more pain that it ever relieves.  I was abrupt and unsympathetic with attempted suicides. I made sure I followed standing orders to the letter and got them to the hospital as soon as possible. In my ways I think I provided better care than before. They got to the hospital quicker and got the help the really needed a psychiatrist or psychologist. I don't know if I was right or wrong in my approach, all I know it is the way I did it. As with most challenges on the street in the early days this one came with no handbook. So each of us was left to work our way through them on our own.  


Lodo Grdzak said...

Suicide is a complicated issue. The ability to commit suicide is one of the few things that separates man from the animals. But the reasons people choose it are varied. There's diversity in the suicidal community. Many people who choose this path--particularly those who are successful at it are already so far gone mentally that they can't even take time to consider the ramifications on others. Im talking about serious depression and mental illness. Its not just self-absorption.

RC Huder said...

Understand and well said. As medics we see the one's who attempt much more than the ones who accomplish their goal. As i said it is the way I reacted to the events. The job changes you for better or worse over the years.

Lodo Grdzak said...

You've got a tough job. Bet your good at it.